210 MR. COSTELLO ON THE TORSION OF ARTERIES. 
at M. Amussat’s suggestion, untwisted the knot. No hemor¬ 
rhage followed, although the knot was entirely untwisted. 
Experiment 5.—In another experiment the epiploon of a dog 
was exposed, and a portion of it removed. The divided arteries, 
which were numerous, furnished blood abundantly. They were 
seized and twisted two or three times each, when the hemorrhage 
ceased. 
It would be tedious to prolong the recital of experiments, for 
they invariably, and under whatever circumstances performed, 
furnished the same results. 
Another illustration of the efficacy of torsion will be found in 
the torsion of any given artery, the radial for instance. If a 
syringe be applied higher up, and water be impelled from it 
through the tube of the twisted vessel, the knot will be raised 
up, but it will remain untwisted, and not a drop of water will 
pass, no matter what force we employ. 
In examining minutely what takes place in the twisted artery, 
we find the internal membranes twisted and forming a cone, of 
which the apex is directed towards the heart. If we cut this 
cone longitudinally, it presents a clot of blood which is strongly 
adherent to the inner coat of the artery, and which completely 
stops it up. If we examine the artery, at a certain distance of 
time from the period of the operation, w ? e find this clot and mem¬ 
branes solidified, and the vessel obliterated as far as the next 
collateral. 
So much for experiments on the lower animals. 
The method of torsion has been employed in operations on the 
human body with the same results. M. Amussat himself now 
employs no other haemostatic method, and I can state that he 
has found it successful in castration, in amputations of the 
thighs, arms, 8cc., and in the disarticulation of the shoulder-joint. 
M. Fricke, of Hamburgh, is so satisfied with this method, that 
he employs no other, either in his private practice, or in the 
hospital over which he presides. 
The frequent examinations which M. Amussat has had an op¬ 
portunity of making on the effect of the torsion of arteries, have 
suggested to him another method, which he calls refoulement , or 
pushing back into the arterial tube the divided internal membranes. 
The refoulement of these membranes is effected without any di- 
•/ 
vision of the artery. The vessel is simply laid bare, and seized 
wuth a forceps, beaked in the usual way, but which, above the 
beak, is rounded in both blades. The artery is pressed strongly 
between the rounded part of the blades, and thus the internal 
membranes are cut. Another and a similar pair of forceps is 
now fixed on the flattened vessel, and the membranes are pushed 
